Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME0072947 | FL |
NPI | 1144212291 |
---|---|
Provider Name | Dr. Andrew Matthew Scanameo |
First Address | Tallahassee, FL 32317-6128 |
Second Address | Tallahassee, FL 32308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 18/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
253172100 | (05) | FL |
38001064 | RAILROAD MEDICARE (01) | FL |
41724 | BCBS PROVIDER NUMBER (01) | FL |
F53455 | (02) | FL |